Joseph C. Presti, Jr., MD, FACS, presented “Kaiser Permanente Prostate Cancer Risk Calculator 1.0” for the Grand Rounds in Urology audience in September 2020.
Brian T. Helfand, MD, PhD, Chief of the Division of Urology at NorthShore University HealthSystem in Evanston, Illinois, discusses the growing role of genetic assessment in prostate cancer screening, emphasizing the benefits of finding patients’ single nucleotide polymorphism (SNP)-based polygenic risk score (PRS). He acknowledges the roles of family history and testing for rare pathogenic mutations like BRCA2, ATM, and CHEK2, but observes that the former can change over time and be difficult to accurately obtain, while the latter is only relevant to a small percentage of patients. PRS, or genetic risk score, is a number calculated based on the cumulative variation across multiple SNPs, which is then used to provide an easily interpreted estimate of disease risk that is more informative than family history, improves predictive performance, and is significantly associated with both prostate cancer incidence and mortality. Dr. Helfand concludes by noting that there are currently no agreed upon guidelines for timing and frequency of PSA testing, but genetic assessment, and particularly PRS, could clarify who would benefit from early screening.
Q&A – Summary:
E. David Crawford, MD, Editor-in-Chief of Grand Rounds in Urology and Professor of Urology at the University of California, San Diego, interviews Joseph C. Presti, Jr., MD, FACS, Regional Leader of Urologic Oncology Surgery at Kaiser Permanente Northern California, about Kaiser Permanente’s new prostate cancer risk calculator. They discuss the difficulty of getting urologists and family practitioners to give digital rectal exams (DREs) since they have been found to be a deterrent to men getting screened. Dr. Presti suggests that patients who meet a certain risk threshold based on the calculator that does not include a DRE should then receive one. Drs. Crawford and Presti also discuss the role of PSA, PSA density, and molecular markers in calculating prostate cancer risk.
For more information on genomic testing and prostate cancer, visit our Next Generation Genomics & Biomarkers Learning Center.
How to cite: Presti, Joseph C. “Kaiser Permanente Prostate Cancer Risk Calculator 1.0” September 2020. Accessed Sep 2020. https://grandroundsinurology.com/kaiser-permanente-prostate-cancer-risk-calculator-1-0/